Have you ever wondered about how you and your loved ones interact and bond with one another? A flawed attachment style can make your experience on this Earth a living hell even when it's a personality trait of only one of the people involved in a relationship (regardless of how many people are involved).

How we interact with those closest to us — those we lean on and trust to take care of us — has been one of the most fruitful areas of scientific research in psychology for more than half a century. At present, there are many university laboratories and research centers focused exclusively on deepening our understanding of this matter, such as the Adult Attachment Lab at the University of California, Davis, and the Center for Attachment Research of the Department of Psychology at The New School in New York City, to name a few.

If only for a few minutes you lower your psychological defenses—if you move beyond denial—and answer honestly, you may quickly test yourself to gain a clearer picture, thus obtaining a data-driven scientific assessment of your attachment style. If your loved ones are also willing to respond truthfully, you may all obtain important insights concerning the potential problems, if any, that already exist or that could arise in the future such that these may be avoided or resolved together through cooperation and corrective action. It ought to be noted, however, that testing young children carries with it some complexity, as is discussed in a following sections where all the scientific testing methods currently available are listed, including those tailored to identify relational tendencies in toddlers.

A link to the ECR-R, a leading psychological assessment of adult attachment styles is provided below, in the same manner that is always done here at Cognitive Dynamics. Not only is this personality test free of charge and not that time-consuming, but also the results it will output are so straightforward that anyone can understand them.



Nevertheless, before delving into the test, it is imperative to review the background of Attachment Theory, the model's history, its various classifications and their key features, as well as to point out some of the cognitive dynamics that frequently occur. Though some of what follows is a bit technical in nature, you ought to read it in its entirety in order to better grasp the implications of the results and the possible outcomes that routinely follow the utilization (and internalization) of each bonding strategy.

What are Attachment Styles? Diagnostic Status and Related Diagnoses

To begin, it is important to preemptively prevent a possible confusion. While attachment styles do describe mental and behavioral patterns, these are not generally diagnostic categories in a clinical setting. Even the most harmful styles do not constitute diagnosable mental disorders under the two presently dominant classification systems: the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), developed by the American Psychiatric Association — a simplistic yet detailed gargantuan book that can be downloaded in full for free here and constitutes the officialdom in psychiatry and clinical psychology in the United States of America (hence, HIGHLY RECOMMENDED TO HAVE AT HAND!)— and the ICD-10 (International Classification of Disease) created by the United Nations' World Health Organization (WHO), which provides codes for all known diseases, wherein mental disorders are coded and defined under "Chapter V: Mental and behavioral disorders". [*Secure WHO site here yet only a secured connection is allowed to enter.]  To those who may be interested, there is a Medicare search engine for the ICD-10 categories either via code or by keywords, though this federal platform appears to still be a work in progress. You may download the full ICD-10's Bluebook and Greenbook by clicking on these links.

The Greenbook provides the full list of codes for mental disorders and the criteria that must be satisfied to assign each diagnosis. The Bluebook, in contrast, provides the psychopathology codes but, instead of formal diagnostic criteria, it offers clinical descriptions and guidelines to help practitioners in their identification of the disorders. The Bluebook discussions may be of immense value not only to professionals attempting to arrive at optimal classifications but also to the layperson who may thus grasp the basic truth that mental disorders are all different, even within each code type, such that semantically these are nothing if not vague gray areas or, differently stated: if a person has HIV... well... there have a Human Immunodeficiency Virus inside them and that is a truth that can be tested, retested, and will not change unless the countless HIV organisms are killed either via drug therapy or through a powerful (or chemically aided) psychoneuroimmunological response, but the same is not true of a mental disorder. Most people today consider a psychopathology as a disease, as an illness quite alike—if not exactly like—HIV, any strain of influenza, or a fungal infection like sarcoidosis.

This kind of thinking is not only wrong as a matter of fact, it also stigmatizes the person diagnosed and, if the diagnosed individual also thinks this way, easily leads to a self-fulfilling prophecy that leads to cognitive deterioration because the label given comes to define them. Ever met a kooky person that when their behavior is called out simply replies that it is okay because they are bipolar and they can't help it? People love excuses, and they also love to play the role of victim. The seldom stated truth is that mental disorder are closer to being nominalistic labels (sort of like conceptual placeholders) than to being diseases similar to those caused by viruses, bacteria, parasites, fungi, or genetic mutations.

Drug-related marketing over the past decades has had a lot to do with spreading this misshapen analogy by bombarding the public with propaganda that employ declarative sentences such as "Major Depression Disorder is caused by a chemical imbalance in the brain", an assertion that presupposes a philosophical ideology known as mind-body dualism that most people readily accept and want to adopt largely because it is congruous with their preexisting spiritual and religious conceptions. Nevertheless, dualism is not only philosophically wrongheaded, it is scientifically unsound to the point that, in our day and age, it hinders progress in Psychology and the field of Cognitive Science more generally considered. Persistent major depression—to continue the same example—isn't caused by a chemical imbalance in the brain. The chemical imbalance IS the depression. Minds are neither separate from bodies, nor are minds caused by bodies. This kind of belief is gibberish, the stuff of a millenary, pre-scientific, folk psychology that societies and even many practitioners have not been able to rid themselves of. To put it bluntly: psychological disorders are physical through and through.

Still, just because mental deviations are physical this does not make the analogy to diseases stemming from viruses an accurate depiction because it is one thing to have large quantities of a harmful type of virus, fungi, parasite, or bacteria living inside you and it is quite another to have a pernicious neural pattern the repetitive activation of which leads to certain outcomes that hinder the quality of a person's everyday life. In the former case, the virus or bacteria must be killed or purged enough to eliminate the ability to cause a disease, but in the latter case a sudden change in the related behaviors is enough to destroy the neural configuration thereby ridding the individual of the mental disorder. The typical neural time-frame for such a change is 3 days, but on many occasions real, lasting change can occur in a matter of seconds. [For more information on neural processing, read How You Know What You Know.]

Just because most people do not change — making psychological diagnoses more stable than need be true — does not mean that a person cannot change. Except in the exceptionally few cases where a disorder results from genetic mutations present at birth, mental disorders can be thwarted by changing their defining behaviors such that the underlying neural networks undergo a rapid process of de-calibration and subsequent reconfiguration that no longer embodies the functions that act out the patterns that had become harmful for day-to-day quality of life. Using a psychological diagnosis as a excuse or justification for being a certain way (e.g., "That's not my fault. I'm bipolar!" or "I'm an alcoholic; I just can't help it.") is a convenient yet self-defeatist form of cowardice. Courage has long been known to be not only a virtue, one of the virtues of self-efficacy, but also a mature psychological defense mechanism, the health-related value of which George E. Vaillant recently attempted to remind us of in the 2011 peer-reviewed journal article "Involuntary coping mechanisms: a psychodynamic perspective". [Test your psychological defenses here, and please read, e.g., "Courage and Fear", or "The Road Not Taken" by Robert Frost.]

Self-actualization (a.k.a., self-realization) has been recognized for millennium, from Aristotle to Abraham Maslow and Lawrence Kohlberg, as a rare and exceptional state reached only by the healthiest few. That infrequency, however, does not entail that it is inaccessible; all it means is that some people focus much, much more of their effort into working on their own mental development than what is common among the general human population.

Back to the topic at hand, the codes of the ICD-10 were been adopted by the DSM-5; however, the DSM-5 includes disorders that the ICD-10 does not recognize and for which it provides no codes.

Click to Enlarge Image. Diagnostic and Statistical Manual of Mental Disorders(DSM-5) title page and basic Table of Contents. A longer, detailed Table of Contents, listing all mental disorder and their ICD-9 and ICD-10 codes appears a few pages later.

Insofar as concerns the diagnostic status of Attachment Styles, I must note that there are disorders that do have a direct link to attachment which result from specific insecure styles, including Reactive Attachment Disorder (ICD-9-CM code 313.89, ICD-10-CM code F94.1) [Note: this dual code format will be followed in the rest of this article because most of the Internet has not kept information up-to-date and still use the old codes and categories, which is potentially dangerous. Please understand that only the second code is currently valid.], Separation Anxiety Disorder (309.21, F93.0), and Avoidant Personality Disorder (301.82, F60.6). Although current norms forbid most diagnoses from being attributed to children, both Reactive Attachment Disorder and Separation Anxiety Disorder are eye-opening exceptions inasmuch as these codes may be issued to infants, not just children, for the purposes of healthcare insurance coverage. Reactive Attachment Disorder (313.89, F94.1) is a consistent and constant emotional withdrawn behavior, originally directed at caregivers, in which the child neither seeks comfort nor responds to comfort given when distressed.

This original pattern later extends into a ubiquitous habit of inhibited minimal responsiveness to others, marked deficiency in the ability to experience positive emotions, along with unexplained bursts of anger, irritability, sadness, or fearfulness during normal circumstances. The disorder is caused by frequently having emotional needs go unfulfilled, regardless of whether physical needs are attended to, a scenario that is generated either by an unresponsive or humiliating caregiver (usually the mother) or by a recurrent shift in caregivers. This disorder is the ultimate, most drastic form of an Insecure Anxious-Avoidant Attachment Style (described in the next section). Almost the exact opposite of Reactive Attachment, Separation Anxiety Disorder (309.21, F93.0) is characterized by excessive fear or anxiety associated with any commonplace departure of caregiver that is necessarily a normal and necessary part of everyday life. The DSM-5 places the following criteria for the designation of the aforementioned clinical label—

Click to Enlarge Image. DSM-5 diagnostic criteria for 309.21 (F93.0) - Separation Anxiety Disorder, which is characterized by a pathological fear, anxiety, and unwillingness to be without the company of a perceived, primary caregiver.

Whereas Reactive Attachment Disorder is an extreme form of the Insecure Anxious-Avoidant Attachment Style, Separation Anxiety Disorder is the maximum expression of an Insecure Anxious-Resistant Attachment Style, otherwise referred to as Ambivalent Attachment because of the characteristic behavioral swings that quickly shift from seeking a caregiver's comfort to outright scolding them for having left even if momentarily. Both attachment styles are described in detailed as pertain infancy in the following section, along with their sub-types and the most frequent developmental trajectories emerging from these. In the final section of this article, the classifications that correspond to these during adulthood are indicated and outlined, with a test being provided so that you may ascertain what your (or your loved one's) attachment style is and what it means for your own personal development and entails for your closest relationships.

Having stated that Attachment Styles are not clinical diagnostic categories, it ought to be observed that their immense psychological importance emerges from their being highly predictive not only of the quality and quantity of a person's later peer relationships but also of the development of a mental disorder and the eventual need to use mental heath services. A 2013 peer-reviewed journal article presenting preliminary results of an ongoing 20 year longitudinal study reports that —

"for each additional withdrawing behavior displayed by mothers in relation to their infant's attachment cues in the Strange Situation Procedure, the likelihood of clinical referral by service providers was increased by 50%."

[Lyons-Ruth, Karlen, Bureau, Jean-Francois, Easterbrooks, M. Ann, Obsuth, Ingrid, Hennighausen, Kate, and Vulliez-Coady, Lauriane (2013) "Parsing the construct of maternal insensitivity: distinct longitudinal pathways associated with early maternal withdrawal". Attachment & Human Development 15 (5–6): 562–582. The previous link is to a preliminary draft, the final edited version is behind a subscription firewall here.]

Click to Enlarge Image. Maternal withdrawal and adolescent outcomes on the SCID in late adolescence.Effect sizes shown are beta for continuous outcomes or eta for dichotomous outcomes. From Pechtel et al. (2012) Shi et al. (2011), and Lyons-Ruth, Brumariu, et al. (2013). Eating disorders and conduct symptoms were unpublished at the date of publication of this graph.

The immense effect of an non-secure attachment style can be readily seen in the very problematic mental disorder, all-too-frequently both misdiagnosed and mistreated by psychologists and psychiatrist alike, known as Borderline Personality Disorder (301.83, F60.3), a disorder that gets its oft-protested name because the individual lives within the thin boundary between psychosis and neurosis. [For a narrative of the professional battle over neurosis as a clinical term, see "Neurosis, psychodynamics, and DSM-III. A history of the controversy."; as for the other term, see "Psychosis: a history of the concept."]

Living at this perilous intersection or borderline means that these individuals often worry about falling into psychosis and/or neurosis (or simply "losing their minds"), yet that very rarely happens — less so than the general population epidemiological averages averages — mainly because they are accustomed to the prodrome symptoms (or prodromal stage) that typically drive other non-borderline individuals into psychological crisis or outright madness because they are unfamiliar with these. And why are borderline people so familiar with these symptoms? It is worth repeating... because they live there! That is why the diagnostic term hasn't been changed like so many others have even with under the duress of massive pressuring and lobbying. ["Vaginismus" anyone? Errhm... I mean... "Genito-Pelvic Pain / Penetration Disorder"... Seriously, they couldn't even come up with a politically correct term so they had to hyphen and backslash three dissimilar terms, none of which capture the disorder as well as did the simpler word "vaginismus" (302.76, F52.6). Isn't it bad enough that this is an absolutely horrible disorder that affects 2% of women worldwide—around 72 million women globally!—and yet is almost never diagnosed and is never treated correctly even though it is easily curable in a week or so because the cure isn't legal in a clinical setting? Truly, current clinical psychology and psychiatry are a complete and utter wasteland. No wonder people prefer to talk to ministers and priests; and why shouldn't it be so if these con-artists-of-the-cloth provide the same service free of charge?]

In the case of Borderline Personality Disorder, which is often co-morbid with Post-Traumatic Stress Disorder (309.81, F43.10), the data show that early caregiver deficiency is more predictive of the disorder's symptomatology levels than is the severity of the abuse that the individual has received.

Click to Enlarge Image. Degree of Borderline Personality Disorder symptoms is predicted to a greater extent by caregiver deficiency than by childhood physical, psychological, and/or sexual abuse.

Many mothers play victim, complaining that everything always gets blamed on the mother. Perhaps Freud exaggerated a bit, which has led to the cultural spread of the belief that mothers are responsible for the issues of their offspring, and so, in their defense, I would like to suggest that it is the caregivers, not necessarily the mothers, that are of extreme importance. Nevertheless, mothers are typically the primary caregivers in societies throughout the Earth and the reason for this is a natural one, mainly that mothers provide most of the nourishment and warmth that an infant requires and receives during the first year of life. So, if you are a mother and you want to use the meme that mothers get blamed for everything, possibly to guilt trip the adolescent or young adult that no one obligated you to create, don't blame Sigmund Freud; go ahead and blame nature (or God, or the Holy Spirit, or gods, or whatever other imaginary entity you enjoy cursing at the most). Even as a man who is now a primary caregiver to his offspring, it is still impossible for me to understate the role of maternal presence in the eventual developmental outcome of any child. The following chart illustrates the most common effects and cognitive trajectories resulting from lack of maternal involvement and maternal withdrawal behaviors, and it is a scary picture.

Click to Enlarge Image. Developmental outcomes and mental disorders that have been linked to maternal withdrawal behaviors and to maternal lack of involvement during infancy, tested from infancy, through childhood, into 20 years of age.

The assessment personality test for adults provided in this article, which is free of charge and takes little time to complete, produces a graph exactly like the one below, where the blue dot marks not only a person's bonding style to their partner but also that tendency's psychosocial strength and its particular tendencies . [If anyone is wondering how I got that particularly healthy chart, yes, those are my own bonafide results. :) ] Given the aforementioned outcomes, you may grasp the immense importance of taking this test, of talking your partner into taking it too, and of continuing to read this article through to the end in order to grasp the cognitive dynamics that result in adulthood such that you may break the cycles and not pass them off onto your children. Just think of both the emotional and material costs that you could spare yourself of!

Click to Enlarge Image. Example results from the free online assessment provided of adult Attachment Style. The four quadrants graph an adult's tendency, its strength, and inclinations. Top left = Secure; Top right = Preoccupied; Bottom left = Dismissive; Bottom right = Fearful. These adult bonding patterns, described the final section, typically follow the cognitive dynamics set in motion by the attachment style acquired during infancy - the order of the terms above corresponds to the order listed below. Healthy graph shown are my bonafide results.

Infant Attachment Styles: Frequent Developmental Trajectories

There are 4 main attachment styles adopted by infants in response to the behavior of their caregivers:

1. Secure Attachment
2. Anxious-Resistant Insecure Attachment, also known as Insecure Ambivalent Attachment
3. Anxious-Avoidant Insecure Attachment
4. Disorganized / Disoriented Insecure Attachment

Each style has subcategories, listed at the end of this section. The following descriptions are simplified yet accurate summaries of the overall tendencies. Secure infants will readily explore the surroundings, interact with strangers, show being upset when their caregiver departs, and exhibit happiness upon their return.

Secure attachment develops if caregivers:

• Are readily available to the infant when he or she feels a caregiver is needed
• Are able to satisfy the infant's needs in an optimal manner
• Consistently provide a "safe base" that affords the infant a feeling of safety that allows him or her to explore the surrounding environment and to which they can return whenever the infant feels a need to be protected

The aforementioned characteristics ought not to be confused with over-protectiveness or unnecessary intrusion into the child's life. The caregiver needs to be perceived as reliable, well-meaning, responsive, as someone who is there when needed, not as someone who is always there. Children need to explore the world freely, at their own pace, but their defenselessness requires a caregiver to be somewhere known such that the child can seek their protection whenever they see fit. As the child becomes more secure and the caregivers proves to be dependable, both the willingness to venture out and the perimeter around the base that is deemed safe to explore progressively increase. This leads to increased learning, which in turn produces happiness, and a faster development of skills, cognitive abilities, and general intelligence, the combination of which has a massive, lasting impact on a mind's self-esteem. The beneficial effects of the resulting positive cycle should be easy to grasp, and the data accumulated through decades of experimental studies shows that a secure style usually leads later in life to better peer relationship, both insofar as their quantity and quality, as well as academic success, occupational competency, overall happiness, personal wellness, and physical health. Even if the parenting quality deteriorates, the lasting protective effect of early security tend to remain. Of course, as these are probabilistic tendencies, it is by no means guaranteed that no mental disorder will develop, and the inverse is true too for the styles described below.

[Cognitive Dynamics original article: The prototypical relations between Secure Attachment and specific MMPI-2 scales, Enneagram Personality Types, Myers-Briggs  Jungian archetypes, and the mature, neurotic, and immature scales measured by the Defense Style Questionnaire.  COMING SOON]

In contrast to secure attachment, anxious-resistant insecure infants tend not to interact with strangers even when their caregiver is present. Moreover, though when their guardian leaves the resistant infant exhibits evident distress, once they come back the infant uses cues signaling anger or helplessness to foster closeness instead of the natural behavior of approaching them directly. These infants barely explore their surroundings even when their caregiver is present.

Anxious-resistant attachment is an adaptation to a caregivers whose behavior is:

• Frequently incoherent inasmuch as the rules that underlie their responses to the child or the application of these rules. The incoherence lies either in the behavioral pattern of a single parent, or in the lack of coordination between primary caregivers, thereby acting incoherently when grouped by the infant into the concept of "those who satisfy my needs".
• Unreliable. The combination of unreliability with incoherence yields the correct neural generalization that behavioral responses to expressed are unpredictable. Therefore, since the infant cannot arrive at the principles guiding the caretakers' actions, the ensuing feeling is that no such principles exist, which is why these infants do not explore even when their caregiver is nearby. Why would they if don't even know if their "base" will be there when they turn back around? A human infant is very helpless by nature and the world is perceived by all infants as wrought with dangers; without a reliable base to return to, their surrounding environment is unassailable.
• Inconsistent insofar as simply being there, that is, providing their ongoing presence or support in a way that respond to the infant's needs as these emerge. However, since the caregivers are sometimes available, responsive, and do treat the infant fairly well as a general rule, the infant continues to seek out their presence, love, and affection, doing so with more fervor than all other attachment styles.

As ambivalent infants grow up they tend to develop greater interpersonal sensitivity, a tendency to think obsessively about their loved ones, and an accompanying fear of loss and abandonment. Related preoccupations accumulate progressively, flooding the mind with mostly useless thoughts that consume time better spent on productive actions or coping maneuvers. Worrying by itself decreases the power and speed of cognitive capacities, yet the mind's deceleration is exponentially worse when coupled with persistent fear and anxiety. This cognitive debilitation often facilitates the occurrence of a drawn-out chain of personal, familial, educational, occupational, and relationship failures; however, the anxious-preoccupied adult typically finds a way to shield their self-esteem from taking a nosedive through a defensive amalgamation of mechanisms such as ego inflation, externalization of blame, projection, reaction-formation, fantasy, wishful thinking, and hypomanic activation. The deployment of these compensations tend to achieve its goal, such that anxious-preoccupied adults do not report significantly lower self-esteem than those with a secure bonding style, but this strategy isn't without risks as their chosen dynamics' trajectories can backfire through the emergence of a wide-array of mental disorders, among which are noteworthy are Generalized Anxiety Disorder (300.02, F41.1), Panic Disorder (300.01, F41.0), Oppositional Defiant Disorder (313.81, F91.3), Histrionic Personality Disorder (301.50, F60.4), Bipolar Disorders I & II (296.40-296.56 & 296.89, F31 with decimals as subtypes), and the sudden onset of a Psychosis (297.1, 298.8, 298.9, F22, F23, F28, F29)of relatively short duration.

[Cognitive Dynamics original article: The prototypical relations between Insecure Anxious-Preoccupied Attachment and specific MMPI-2 scales, Enneagram Personality Types, Myers-Briggs Jungian archetypes and the mature, neurotic, and immature scales measured by the Defense Style Questionnaire. COMING SOON]

Anxious-avoidant insecure infants ignore caregivers and attempt to hide the emotions experienced. Even when they attempt to approach their caregiver, they abort the process midway, at times repeating the approach-abort sequence several times. This style is a covert strategy to maintain a close enough distance to their guardian to feel safe without risking being overwhelmed by the uncontrollable emotions that would be evoked should greater proximity be attempted. That they do not look anxious is just a mask, a fact that can be readily confirmed by measuring the clear-cut shifts in cardiovascular activity when their overtly hidden distress sets in.

An anxious-avoidant attachment style is a learned adaptation to guardians that:

• repeatedly reject endeavors to obtain closeness.
• are routinely are unresponsive to need-based requests.
• do not attend to the needs expressed by the infant.
• is incompetent inasmuch as meeting the infant's needs.
• display negative affect frequently but not always.
• rebuff the infant's attempt at achieving greater closeness, either via depriving attention, showing anger (or physically hitting), or acting in a way that is an overt attempt at causing humiliation or shame.

Caregiving behavior mixing the traits above conduces the infant brain's neural network to infer that communication is useless and counterproductive, and consequently the infants begins to camouflage their distress through an aloof and unresponsive demeanor. This behavior is analogous to the infant retaliating by displaying—"You don't care about me, so I don't care about you". Sadly, parents may be so neurotic and/or self-involved that not only will they not notice what the infant is trying to portray, but also the baby's new behavior is found to be convenient because, in practice, it allows the parents to dedicate even less time and attention to their caregiver duties, thereby reinforcing and cementing the pattern, making life even more miserable for the infant in a manner that starts a vicious cycle which often proceeds uncorrected far into adulthood. Have you ever heard a self-involved person say something to the effect of "My baby was the best; he never cried or threw tantrums and was barely any work at all!"? Well, now you know why.

Anxious-avoidant infants do not explore much, do not display anger or any type of suffering when the caregiver leaves, and either turn away, ignore, or execute aborted approaches when he or she returns (i.e., they reject their rejecter). If the caregivers' behavior goes unchecked and this style proceeds without altering course, these cognitive dynamics tend to progress along a couple of distinct trajectories. On the one hand, the mask may stay as just a mask yet ultimately prove ineffective insofar as getting basic needs satisfied, which could evolve intoAvoidant Personality Disorder (301.82, F60.6), Borderline Personality Disorder (301.83, F60.3), Dysthymia (a.k.a., Persistent Depressive Disorder, 300.4, F34.1), or Schizotypal Personality Disorder (301.22, F21). On the other hand, the overt mask can slowly become a psychological reality conducive to disorders such as Depersonalization / Derealization Disorder (300.6, F48.1), Schizoid Personality Disorder (301.20, F60.1), Antisocial Personality Disorder (301.7, F60.2; see the "Discussion" section at the end of Shi et al. (2012) "Childhood Maltreatment and Prospectively Observed Quality of Early Care as Predictors of Antisocial Personality Disorder Features", Infant Mental Health Journal, Jan-Feb 33,1:55-96 that reports findings indicating that it is not the infant attachment style but rather the mother's avoidance and failure to interact with the child directly, for example by soothing the child with toys instead of via human contact, that predicts Antisocial Personality in adults), among others.

The anxious-avoidant attachment style is the most likely to result in adult low self-esteem. It is also the more conductive in drug abuse and substance dependence (since the DSM-5 dropped the use of Substance Abuse Disorder and Substance Dependence Disorder, replacing it by a long list defined by the particular drug involved, the corresponding codes are too many to bother to list).

[Cognitive Dynamics original article: The prototypical relations between Insecure Anxious-Avoidant Attachment and specific MMPI-2 scales, Enneagram Personality Types, Myers-Briggs Jungian archetypes, and the mature, neurotic, and immature scales measured by the Defense Style Questionnaire. COMING SOON]

Disorganized/Disoriented attachment puzzled researchers initially, so much so that many subjects were improperly classified in the early experiments, until Mary Main discerned the pattern once enough data had been accumulated and added this fourth classification. Infants with a disorganized attachment style display tense and jerky movements in an attempt to stop their impulse to cry—movements that stop when they do cry—because they are afraid of what their caregiver might do to them in response to any sign of weakness. Overwhelmed by fear, these infants' behavior is inconsistent, contradictory, and often display clear signs of psychological dissociation; nonetheless, about half of these infants still approach their caregivers without resistance or avoidance. This disoriented attachment style, unlike the prior three, may emerge as an adaptation to several different types of events, including—

• physical and sexual abuse
• maternal trauma, which typically occurs shortly prior or following (or during) childbirth
• the mother had suffered (when is irrelevant) a major loss which was never fully processed and, hence, had not overcome, such as the death of a parent, best friend, or beloved mate
• maternal major depression, typically (though not always) as a consequence resulting from one of the prior two points

Maternal trauma and loss accompanies over 50% of infants classified under this category. Strangely enough, though the disorganized/disoriented style is associated with the worst forms of neglect and abuse (both physical and psychological), the two insecure attachments mentioned above turn out to afford distinctively worse outcomes during development. How can this be? The reason is that infants displaying this last style develop a strategy in which they alternate between approaching strategies, experimenting with all the manners of action displayed by secure, ambivalent, and avoidant infants, like little pragmatists trying to figure out what courses of actions work best in which situation and in relation to particular people and groups. This scientific way of testing strategies through interaction makes psychological change not only possible but likely. Were the child to become embedded in a healthier or more nourishing environment, he or she will quickly adapt accordingly, rendering the secure attachment style as something that is always within arms rich. Sadly, however, what is unlikely is that the child will have the opportunity to immerse in healthier settings with access to well-adjusted people and a wide array of enriching stimuli.

[Cognitive Dynamics original article: The prototypical relations between Disorganized/Disoriented Insecure Attachment and specific MMPI-2 scales, Enneagram Personality Types, Myers-Briggs Jungian archetypes, and the mature, neurotic, and immature scales measured by the Defense Style Questionnaire. COMING SOON]

The following list outlines the different infant attachment styles and their subtypes. Asterisks mark types for to which I have provided my own terminology, mainly because I do not like referring to people in terms of letter-number codes has been done by researchers since the beginning and still today. The codes preceding the terms are the ones that have been and continue to be employed.

• B: Secure Attachment
• B1: Secure Reserved
• Even as they use their caregivers as a base to explore and as aides in learning new skills, this style is characterized by a lesser need for contact and a repeated seeking of autonomy, independence, and privacy, preferring to develop new abilities on their own when able to yet seeking assistance when facing difficulty. Being reserved isn't introverted, which may lead later in life to the gray area between introversion and extroversion.
• B2: Secure Inhibited
• These shy introverts require more learning by example and positive reinforcement.  They also seek more independence but, unlike the reserved style, return to approaching the caregiver after a long period of time; however, infants of both styles do not resist physical contact if the parent initiates it, yet inhibited infants display less mixed feelings than reserved ones.
• B3: Secure Balanced
• Among the secure groups, these are the ones that seek the most physical contact and suffer the most distress after repeated separation. Nevertheless, when the mother is present, the infant isn't preocuppied with her and readily engages in exploring, unlike insecure infants.
• B4: Secure Reactive
• The reactive style is the most clingy and most distressed of the bunch, displaying a constant preocuppation for the place of her mother, but their seeking of contact is much less than in the anxious-resistant insecure styles.
• C: Anxious-Resistant Insecure Attachment, also known as Ambivalent Attachment
• C1: Angry Resistant*
• Seeking out contact is a constant for the angry resistant infant even before the caregiver first leaves. The return of the parent is accompanied by aborted approximations and the child displays a clear angry quality once contact is established, as if to reproach them for having left them.
• C2: Passive Ambivalent*
• These babies show severely limited exploration of the environment. They signal wanting contact instead of approaching, and protest when being put down without resisting it. The resistance increases as more separations happen yet is never as much as the C1 infant and, though distressed, does not exhibit anger
• A: Anxious-Avoidant Insecure Attachment
• A1: Apathetic Avoidant*
• This child shows his disdain by looking away or turning so that the back is turned towards the primary caregiver. When approaching, the apathetic infant will abort that behavior by walking past them. If picked up, the baby does not cuddle and tends to squirm to be put down.
• A2: Reproaching Avoidant*
• Of all the attachment styles, this is the most characterized by mixed feelings. Wanting proximity and approaching at times, the infant still looks or turns away, aborts approaches sometimes, gazes away when picked up and squirm when put down, yet still may protest or resist at times when put down.
• D: Disorganized/Disoriented Insecure Attachment
• Frightened Disorganized**
• With a generalized fear of the world, these infants may seek comfort through physical contact, yet when the mother leaves or the stranger is present, they may exhibit jerky bodily movements, try to hold back tears, may look around frenetically without exploring. When the mother returns, they may scream, run and hide, or grimace, but if the mother makes contact, they do not resist or protest. It may also be the case that strategies belonging to the other groups are carried out in different instances of reunion and/or separation.
• Flooded Disorganized**
• Flooded disorganized children are paralyzed by their conflicting emotions.  Clear signs of dissociation or depersonalization are common.  A flooded disorganized child may start to approach a stranger seeking comfort and lose muscular function upon reaching proximity, falling to the ground, as the fear and internal incoherence becomes so much that it overwhelms their neuronal functions.
• Desperate Disoriented**
• Behave unpredictably insofar as seeking and avoiding physical contact.  May display random emotions that appear to bear no connection to what is going on around them.  Actions may be carried out inconsistently or incoherently towards caregiver, strangers, or when alone.
• Pragmatic Disoriented**
• All actions are available and may be executed, and these may seem to be consistent, leading these to be erroneously classified until test-retest bears out the pragmatic aspect of the disorientation.  The course of action carried out is chosen through the reading of interpersonal cues, such as the other's mood, velocity and calmness of bodily movements, or verbal intonation.  The behavioral trajectory forms on a case-by-case basis. 

*Unofficial terminology of my own creation. Only secure strategies have been given names, though these are still considered loose and unofficial. The styles are usually referred to by the coding system (e.g., C1, C2... as listed) originally develop to classify the infants during the Strange Situation Protocol experiments [see next section].  
**The delayed identification of the Disorganized/Disoriented category and the mix of behaviors grouped therein has yet to be standardized. Traditionally, many studies have excluded this classification because it is rare, consisting of less than 5% of cases; thus, very large samples are required in order to obtain statistically significant results.  However, much of the Attachment Theory related grant funding is currently being directed at understanding this category, mainly because those are the humans most at risk, most likely to be costly to governments, and most responsive to social interventions during middle-childhood.  The distinctions and descriptions above represent unofficial approximations based on past findings and the descriptions of leading theorists.

History of Attachment Theory and the Attachment Styles Model

Attachment Theory stems from the seminal work of John Bowlby, who began publishing papers on the subject in 1958 and developed the ideas into a full-blown model in the trilogy of books Attachment and Loss, with Volume I: Attachment being published in 1969, Volume II: Separation: Anxiety & Anger in 1972, and finally Volume III: Loss: Sadness & Depression becoming available in 1980. Mary Ainsworth developed the Strange Situation Protocol to observe empirically infants behavior from 12 months to 20 months of age. The protocol was usually carried out as follows:

• Episode 1: Mother (or other primary caregiver), Baby, Experimenter (30 seconds)
• Episode 2: Mother, Baby (3 mins)
• Episode 3: Mother, Baby, Stranger (3 mins or less)
• Episode 4: Stranger, Baby (3 mins)
• Episode 5: Mother, Baby (3 mins)
• Episode 6: Baby Alone (3 mins or less)
• Episode 7: Stranger, Baby (3 mins or less)
• Episode 8: Mother, Baby (3 mins)

Though many observations were important in all "Episodes", the key observations are mostly obtained in Episode 5 and Episode 8 when how the infant responds to the caregiver's return provides the key characteristics of their behavioral pattern associated to their primary caregiver, usually their mother. The classification system that resulted from these and further experiments are commonly referred to as Attachment Styles.

Many other experimental protocols and questionnaires have been developed over the years, some closely controlling variables and others taking a more naturalistic approach.  Developing instruments to follow individuals as they grow has been pivotal both to evidence the empirical robustness of the theory, particularly the predictions entailed by it, and to be able to follow the stability of infant styles and the frequency with which these can and do change.   The following is a list of the different methods-  

Other controlled variables methods for minors

1. Preschool Strange Situation (for 3 to 4 y/o) - Modifies the original protocol to elicit stress by having longer separations, varying the gender and role of the stranger, or simply leaving the child alone twice, and the classification system integrates talking as a form of maintaining contact.  Besides the 4 main style categories, participating children are measured on a 9-point security scale and 7-point one for avoidance.
2. Main and Cassidy attachment classification system (for 6 y/o) - The children are left alone once, for a full hour.
3. Preschool Assessment of Attachment (PAA; for 18 m/o to 5 y/o) - Replaces the categories of avoidant with "defended" and ambivalent with "coercive", with no type for disorganized, and attempts to distinct dangerous compulsive and obsessive patterns.
4. Marschak Interaction Method (MIM) and MIM Behavior Rating Scale (MIMBRS) - Two standardized variants of a structured observation of parent-child interaction.

Naturalistic methods for minors

Attachment Q-set (1 to 5 y/o) - Set observation periods across contexts, covering almost a hundred data points about attachment, exploration, emotional responses, and social cognition.  It rates the child from 1.0 to -1.0, from very secure to very insecure, without sub-specifications. Representational methods - Use of story stems, narratives, and pictures, along with dolls standing in for family members, so that the child can enact a story that is begun by the interviewer.

1. MacArthur Story Completion Test (3 to 8 y/o)
2. Story Stem Assessment Profile (SSAP; 4 to 8 y/o)
3. Attachment Doll Play Assessment (4.5 to 11 y/o)
4. Manchester Child Attachment Story Task (MCAST; 4 to 8.5 y/o) - Four story stem with play dolls with a semi-structure methodology to assess the child's mental representations of their relationship with their primary caregiver by using two dolls and a doll house, with the stories presented by arousing emotions to more accurately evoke the attachment ideas in an engaging manner.  The session is videotaped for rating purposes, with an attachment classification given, and special attention is placed on disorganized attachment.  The MCAST has been progressively been tested and used across cultural contests, and training is required for proper use.
5. Attachment Story Completion Task (ASCT; 3 to 9 y/o) - Child resolves 5 stories involving that induce stress using props as family figures in a 30 minute interview.

Interview methods 

1. Child Attachment Interview (CAI; 7 to 11 y/o) - Focuses on relationship to parents and events known to elicit attachment styles in a semi-structured interview that is scored on verbal and non-verbal communication.
2. Disturbances of Attachment Interview (DAI) - Assesses Reactive Attachment Disorder [see link and ICD/DSM code in first subsection of this article] as well as discriminated adult, preferred adult, distressed comfort-seeking, response to offered comfort, social reciprocity, emotional reciprocity, emotional regulation, "safe base" use while exploring, reticence with strangers, willingness to follow strangers, self-endangerment, vigilance, hypercompliance (a.k.a. compulsive obedience; see last list in prior section), excessive clinging to caregiver, and role reversal.
3. Attachment Interview for Childhood and Adolescence (AICA) - An age-appropriate adaptation of the Adult Attachment Interview (AII) that classifies participants as secure, preoccupied [analogous to Resistant/Ambivalent, same as test provided below] , dismissing [analogous to avoidant; same as test provided below], and unresolved [analogous to disorganized/disoriented in the standard classification system for infants, and to fearful/avoidant in the test provided below] 

Methods for adults:

1. Adult Attachment Interview (AAI) - A collaboration with Mary Main, who devised the disorganized style classification, the AAI is a 20 question, one hour semi-structured interview that has yielded solid supporting data since its creation in 1984.  The AAI looks at style functions via childhood memories, rating coherence and content.
2. Adult Attachment Projective Picture System (AAP) - Participants tell stories about 8 pictures presented to them.  Data obtained through the AAP, employed since 1999, overwhelmingly corroborate the ratings obtained through the AAI, and viceversa.
3. Relationship Questionnaire (RQ-CV) - A very simple 4 statement question from which participants must pick the one statement they most identify with.  The questionnaire was validated in 62 cultures using independent psychological tests that measure traits associated with the different styles.  The RQ-CV spawned a wide-array of modifications, varying mainly insofar as how items are rated, but the most used currently is the next measurement system listed. 
4. Experiences in Close Relationships - Revised (ECR-R) - First created in 1998 and revised in 2000, this is the assessment test provided at the end of this article. The items measure relational anxiety, on the one hand, and avoidance, on the other.

Adult Relationship Attachment Styles

An individual's attachment style may change over the years depending on the quality of their experiences during development. Although romantic relationships do not share many traits with caregiver-infant relationships, not only do romantic links involve many of the core tenets of earlier attachments, but also traces of those first attachments do tend to carry over into adulthood, remaining constant in many cases. The adult romantic attachment styles are:

• Secure
• Also sometimes called autonomous when describing adults, though the category secure is much more on point because a secure person doesn't necessarily have to be autonomous even if not clingy.  The Avoidant Style ("dismissing" below) tends much more to the objective of autonomy than most secure people do.
• Preoccupied
• Corresponds to Insecure Anxious-Resistant, otherwise known as Insecure Ambivalent Attachment.
• Dismissive (or Dismissing)
• Corresponds to the Insecure Avoidant category in infants.
• Fearful
• Corresponds to Insecure Disorganized / Disoriented Attachment in infants. The use of the term fearful is unfortunate, as explained below. This category is probably not even the most fearful of the bunch as people with this attachment style tend to swing wildly between periods of intense bonding and periods of total evasion, the latter following precisely because of the fear that is caused by the intensity of the former. Considering that fact, both disorganized and disoriented make for more accurate nomenclature.

These four styles can be graphed by plotting them in a four quadrant chart with Anxiety as the X-axis and Avoidance as the Y-axis.  Bartholomew and Horowitz, the creators of the simple Relationship Questionnaire (RQ-CV), tried to arrive at some analytic elegance when they posted the styles as aligning with self-esteem and the esteem of others as shown in the table below.

The concept configuration upon which ECR-R results are based. Please read the explanations and caveats explained in this section to understand why this framework, though helpful, tends to mislead.

But one ought to be skeptical of the anxiety axis given what was noted earlier about infants with an avoidant style, that is, they appear as if they are not anxious but their cardiovascular activity shows otherwise. The lack of anxiety is, thus, merely a façade, an act that does not reflect the inner life of that person at all; stated differently, the calm demeanor is nothing more than a defense mechanism, a fact that usually reveals itself when the dismissing individual finally has a sudden and harsh outburst of hostility that the person appears unable or barely able to control. Though the four quadrant format of description has been empirically proven to be of value, these proposed continuum are not just misleading, they are also factually wrong, and the available data show this clearly.

Using the Experiences in Close Relationship questionnaire provided below and the "Questionario della Gelosia" (QUEGE) as an independent, culturally-appropriate measure of jealousy as corroboration, Marazziti et al. (2010), working out of the Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnology at the University of Pisa, found that fearful style participants scored higher on the fear of loss only, dismissive individuals scored lower in self-esteem, yet the preoccupied group recorded higher scores on obsessionality, interpersonal sensitivity, and fear of loss. Yet these findings contradict almost everything in the way the axis are conceived in the chart above.

To start, dismissive individuals are marked as having a positive view of themselves; however, that is the group that showed the lowest scores on self-esteem. Similarly, it is quite a stretch to say that preoccupied individuals who obsess over their partner, fear losing them, and also report higher sensitivity towards them have a positive view of their partner; clearly, someone who feels that way most likely does not have a positive view of their partner. If their view was positive, why would they obsess and fear and be so sensitive to every little painful word and act that their partner does to them?

Even as infants and all throughout childhood, the preoccupied style is characterized by a distinctively angry or resentful quality. As for the fearful category, there is too much to say to be able to express it here; suffice it to say that the very nomenclature is unjust—all insecure people are fearful by definition! They may express it in different ways, but they are all similar in that regard. They also all tend towards having low self-esteem, and though it is true that some achieve high self-esteem, usually through the dominion of a skill or a field of knowledge, still more use ego inflation as camouflage. 
These last point—the overwhelming pain of fear and constant anxiety—are constantly being evidenced, with studies leading to peer-reviewed journal articles such as Davies et al. (2009) "Insecure attachment is associated with chronic widespread pain" and McCarthy et al. (2012) "Attachment Style Predicts Anxiety in Undergraduates' Romantic Relationships".

Though the avoidant or dismissive style is harder to crack and potentially leads to worst outcomes, it is the preoccupied group that has the clearest vicious cycle, one that most people who have actively dated have encountered at one point or another. Whereas the dismissive function may be found to be convenient, the preoccupied or ambivalent mode of operation can be quite the nuisance. When dysfunctional, the avoidant relationship pattern proceeds like this—
 

Click to enlarge. Diagram of the vicious cycle that a person with an  Insecure Avoidant (a.k.a., Dismissive) Attachment Style may display repeatedly over the course of a relationship.

In contrast, the dysfunctional vicious cycle of the preoccupied style in a relationship proceeds as follows—

Click to enlarge. Diagram of the vicious cycle that a person with an Insecure Ambivalent (a.k.a., Anxious Resistant, or Preoccupied) Attachment Style may become stuck in during a relationship.

• Secure Attachment
• Secure Consistent-Bonding
• Because of how their family dynamic progressed over time, combined with contextual proximity, these secure individuals tend to stay close to their parents and/or their extended family while at the same time setting healthy boundaries to shield their privacy, autonomy, personal development, and overall wellbeing. People with insecure attachments are often more closely tied to the immediate and extended families, but they fail to set similar boundaries, which results in further damage being inflicted upon them and makes it more likely for them to repeat the pattern with their own children.
• Secure Independent
• Though these individuals may still be able to open up to their parents and state what they feel needs to be stated, they find that keeping their ascendancy and extended family at a distance provides for greater wellbeing, perhaps (but not necessarily) because family dynamics have deteriorated over the years.
• Secure Pragmatic
• These secure adults read the people, family systems, and situations in order to determine whether closeness or distance is best at any given point.
• Insecure Anxious-Preoccupied Attachment
• Angry-Oppositional Planner*
• Having been angry children who frequently lashed out, though not usually rebelled, against their parents, as adults angry-oppositional plan ferociously but seldom have the persistence and perseverance to complete their plans.  As workers or in relationships, they oppose almost any instruction that is given to them.
• Reserved-Obedient Planner*
• Having explored very little throughout their childhood, reserved-obedient adults tend not to have the skills necessary to venture out on their own.  Almost opposite to the angry-oppositional adult, these individuals crave structure, organization, and to be given guidance and instruction at all times.  Their anger gets repressed, suppressed, or sublimated into immersing themselves in their occupation.
• A: Insecure Anxious-Avoidant Attachment
• Aloof Avoidant
• Having dissimulated their true emotions as children, the aloof avoidant adult can no longer recognize the emotions, be them positive or negative.  Negative emotions have them draw a blank.  Positive emotions may prove to be disorienting and even cause nausea or vertigo-like feelings.  As a result, any strong emotion is stumped immediately and the person often fails to recognize that any such drowned emotion existed.
• Approaching-Reproaching Avoidant*
• All the insecure anxious-avoidant attachment styles may show some degree of this dynamic, but some people have it as a strict modus operandi (MO) without the characteristics of the other styles.  Succinctly, these adults seek closeness when negative emotions are felt or expressed and distance when positive emotional states appear in the context of the relationship.
• Compulsive Obsessional*
• Appearing often before middle-childhood and progressively intensifying into adulthood, as avoidance of affect, vulnerability, and intimacy, be it with family or close peers, result in negative feelings, thoughts, generating anxiety and low self-esteem. Compulsive acts, often learned from surrounding family members, are executed to occupy the mind thereby temporarily suppressing the stress provoking perceptions.  Low self-esteem, anxiety, and the longing to keep their safe base at close enough proximity combine to generate a compulsive obedience to the parents, though that mode usually does not extend to the rest of the world because, intuitively, they obtain little benefit from being obedient.  The attachments have no authentic intimacy, but closeness is kept via the habit of satisfying parental requests, which some of the time involves confused or inverted roles where the child takes care of the parents more than the parents care for them.  Because negative ideas are suppressed whenever possible, brief yet severe outburst of anger and hostility ensue.
• D: Disorganized/Disoriented Insecure Attachment
• Frightened Disorganized*
• With a generalized fear of the world, these adults may seek comfort through physical contact, yet may exhibit jerky movements or tense body parts, as well as trying to hold back tears.  They long for an intimacy that they do not believe they are capable of achieving themselves. If achieved, the risk of flight from the relationship becomes very high, mainly to spare the person they love from what they see as their own nature.
•  Volatile Disorganized*
• Developing from flooded disorganized children, paralyzed by their conflicting emotions, these adults swing between intense bonds and the feeling of not being there.  Clear signs of dissociation or depersonalization are common.  Their  internal incoherence may lead to very pernicious conditions, like recurring dissociative fugues or sexual dysfunctions, like vaginismus in women or both premature ejaculation and the inability to sustain sexual excitement in men.
• Seesawing Disoriented*
• These adults behave unpredictably, and their internal states feel like a rapidly moving pendulum that sometimes reaches the full edge but most of the time just cycles rapidly somewhere in the middle.  Inconsistency may be readily perceived by their romantic partners.
• Pragmatic Disoriented*
• Perhaps the best among the disorganized/disoriented, all styles are available to these individuals to be executed depending on the partner and the context.  The course of action carried out is chosen through the reading of interpersonal cues, such as the other's mood, velocity and calmness of bodily movements, or verbal intonation.  If these adults become involved with somebody with a secure attachment style, they may assimilate that style for good; hence, they have the best prognosis out of all the insecure types.

*Unofficial terminology of my own creation.  See the infant typology above for more information.

Now that you are armed with knowledge of attachment styles and their developmental dynamics, you are ready to go ahead: Test yourself!




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